Angela Sue Moore, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0534062 Issued in KS

Practice address

3510 N Ridge Road
Suite 500
Wichita, KS 67205

Phone

(316) 881-8180

Fax

(316) 881-8329

NPI assigned

Mar 5, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Angela Sue D'Annunzio Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Feb 28, 2023 through Feb 28, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: angela.moore@504542587387908.direct.elationemr.com
• Direct secure messaging: angela.moore@khindirect.org

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1236211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1184864076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 N RIDGE ROAD, SUITE 500",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67205",
            "telephone_number": "316-881-8180",
            "fax_number": "316-881-8239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 N RIDGE ROAD",
            "address_2": "SUITE 500",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67205",
            "telephone_number": "316-881-8180",
            "fax_number": "316-881-8329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANGELA",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-05",
        "last_updated": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0534062",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "47165",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200639670A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1184864076",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "D'ANNUNZIO",
            "middle_name": "SUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Morgan Rae Mooney, DNP, APRN, FNP-C
• Angie Marie Mooneyham, M.S. LMFT
• Alison Anne Moore, DC
• Amber Noel Moore, PMHNP-BC
• Angela Beth Moore, LCMFT
• April Moore
• Ashley Glee Moore, MCP, LCPC
• Brian Lee Moore, CRNA
• Brook Moore, NP-C
• Caprice Moore, CNA

• Family Medicine Physician in Wichita, KS
• Providers in Wichita, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.